With rates of skin cancer on the rise, people with eczema need to be prepared to self-screen for any trouble spots that flaring skin may make it hard to identify
Published On: May 22, 2017
Last Updated On: Jun 22, 2022
If you have atopic dermatitis (AD), you’ve probably heard the terms “atopic march” or “atopic triad.” This is when people with AD also develop asthma, an allergic condition that causes the airways to become swollen and inflamed, allergic rhinitis, or hay fever, which is inflammation in the nose and sinuses. These are known as comorbid conditions or comorbidities of AD.
They can bring with them a variety of other symptoms ranging from a runny nose, sneezing, and itchy eyes to hives, sinus infections, and shortness of breath. Allergies can even lead to life-threatening conditions like anaphylaxis.
Each year, the Asthma and Allergy Foundation of America declares May to be National Asthma and Allergy Awareness Month. Not-so-coincidentally, this happens to be one of the worst times of the year for most asthma and seasonal allergy sufferers.
And while blowing your nose or using an inhaler throughout the day aren’t exactly causes for celebration, think of National Asthma and Allergy Awareness Month as a good time to focus on symptom management. By identifying the allergens that trigger these inflammatory responses in your body, you’re one step closer to getting your AD under control.
So, without further ado, we bring you five environmental allergies (and treatment plans to manage them) with help from Dr. Michael Wein, an allergist-immunologist in Port Saint Lucie, Florida, who is a professor at Florida State University College of Medicine and is affiliated with multiple hospitals in the area.
“Molds are tiny fungi, and the spores float through the air. They seem to cause problems in humid and damp environments and can be found outdoors, in homes and in other buildings. It is a real problem year-round in Florida where I practice,” Wein said.
“If you are allergic to mold, your immune system is overly-sensitive to specific mold spores and treats them as an allergen. There are hundreds of types of molds, most common allergy-causing molds include Alternaria, Aspergillus, Cladosporium and Penicillium.”
Wein suggests staying indoors in an air-conditioned building as much as possible and buy a hygrometer, which measures moisture content in the atmosphere. “In exceptional cases in which asthma is unusually severe, such as Alternaria species–induced asthma in the Midwest, it might be advisable to chat with your doctor [about treatment options],” he suggested.
Pollen, the airborne allergen behind hay fever, is one of the most common aero-allergens and also one of the most difficult to avoid. Especially on days with high pollen counts, those allergic to this irritant may experience seasonal allergy symptoms such as watery eyes, nasal congestion and other annoying symptoms. “Pollens in Florida are most numerous in January through March and, wow, do we have tree pollens,” Wein said.
“Many patients find wonderful relief with over-the-counter treatment (OTC) options. If they cannot avoid the allergen, the FDA has approved several previously ‘prescription only’ medications for OTC use and they include Flonase, Rhinocort, Claritin and Zyrtec”
Other allergy treatment options include allergen immunotherapy, a nasal spray, or allergy shots that work like a vaccine. You can also ask your doctor about allergy testing to see how severe your allergies are and to create an appropriate treatment plan based on the severity.
“The body responds to injected amounts of a particular allergen, given in gradually increasing doses, by developing immunity or tolerance to the allergen,” Wein said. “Patients should base a decision regarding allergy shots on how much time each year is spent suffering with allergy and how well medications and environmental controls are helping.”
Dust mites are microscopic creatures or tiny bugs found in house dust that can live everywhere indoors from mattresses and pillows to upholstered couches and carpets. Cleaning your home regularly can help reduce your exposure to dust mites and improve your quality of life. It’s important to remember to change furnace and air conditioner filters regularly, and use high-quality pleated filters. Consider purchasing dust mite covers made specifically for mattresses and pillows that can help fight allergy symptoms. More NEA Tips here.
“In 2012, on the basis of several studies of dust mite immunotherapy, newly published guidelines suggested that doctors consider allergen immunotherapy in selected patients with atopic dermatitis if they have aeroallergen sensitivity, but it is not FDA approved,” Wein said.
The pharmaceutical manufacturer Merck collaborated with Danish company ALK to develop an immunotherapy tablet for house dust mite–induced allergic rhinitis. The medication, called Odactra, is an alternative to allergy shots and was approved by the FDA in March 2017.
“Animal dander is extremely light-weight and tiny in size and can stay airborne for hours. Levels in homes without animals are generally much lower but can still be detected. Occasionally, high pet allergen levels can be found in households or in schoolrooms without a pet,” Wein said.
If you have a cat or dog, it is not always practical to bathe or shave your pet and expect to be rid of allergens completely. “The proteins are found not simply in the fur, they might also be in a pet’s dander, flakes that come off the skin, saliva and even urine,” Wein explained. “Interestingly, sometimes the pet fur can collect pollen or dust mite allergens and act as a vector for another allergen, but my experience is that this is much less common.” Wash pets at least weekly and consider buying a high-efficiency particulate air (HEPA) filter, he said.
A common environmental allergen you might not want to think about is cockroaches. They often trigger asthma, particularly for children with asthma living in inner cities, Wein said. “The use of a single intervention, insecticidal bait, to reduce cockroach exposure in the home of children with asthma in New Orleans showed intervention homes had significantly fewer cockroaches than did control homes,” he noted, referencing a study published in the Journal of Allergy and Clinical Immunology in January 2017.
“Children in control homes that did not try to eliminate cockroaches had more asthma symptoms and unscheduled health care utilization compared with children living in intervention homes. The strategic placement of insecticidal bait – which is inexpensive, has low toxicity and is widely available – resulted in sustained cockroach elimination over 12 months and was associated with improved asthma outcomes.”
No matter the type of allergy, it’s important to learn how to manage your symptoms and eliminate the allergen’s presence from your life as much as possible. If you experience any common symptoms but are unsure what is the culprit, a skin prick test can help reveal what allergens are irritating you. Along with eliminating exposure to allergens such as grass pollen or ragweed, you can also consider taking an antihistamine or other medication to control your allergic reactions.